Arthritis + rheumatology Flashcards
Juvenile idiopathic arthritis Dx
S/S must be present for 6 weeks
Subtype determined by presentation in 1st 6 months
Juvenile idiopathic arthritis S&S
- pain
- Decreased function
- AM stiffness
- fatigue
- Decreased ROM, muscle strength and length
- growth abnormalities
- asymmetrical posture + movement patterns
- eyes (uveitis)
- effects synovium, tendon sheath synovium, entheses
Juvenile idiopathic arthritis Rx? How common is complete remission?
- Decrease impact of disease
- want child to be physically, socially, and emotionally as normal as possible
- co-Rx w/ OT
- complete remission in 75% kids if occurs before 16
What are the treatment goals for acute, subacute, and chronic stages of idiopathic juvenile arthritis
Acute: maintain ROM and function
Subacute: Increase ROM and strength
Chronic: complex activities/ balance
What type of exercise do both RA and OA pts benefit from
aerobic, resistance, and stretching/ROM - pool is great for both
Contraindication to exercise in RA and OA
- Increased pain, fatigue or AM stiffness
- sudden pain at joint or joint deformity
- joint becomes red, swollen and hot after doing exercise (within 24 hrs)
- Decreased muscle strength and function (local myositis)
- neurological SSx (CV involvement)
- SOB on mild exertion
Precautions to exercise with OA and RA
- watch out for inappropriate exercise: can harm joints (RA: deforming forces)
- swollen joints at risk for capsular stretch and rupture
- OP bone at risk for #
- use machine and resistance bands rather than free weights
Name 5 rheumatology outcome measures
- Health assessment questionnaire
- EuroQoL - 5D
- MACTAR
- Time chair stand test
- Knee injury and OA outcome measure (KOOS) or HOOS
Health Assessment Questionnaire:
What does it measure?
Scoring?
Population?
- difficulty performing ADLs over the past week
- good measure of disease activity
- 5 dimension
- ordinal scale: 0-3
- want a lower score
- most widely used functional measure in rheumatology
- RA
- there is a modified version
EuroQoL - 5D:
What does it measure?
Population?
- QOL profile
- looks at: self care, ADL, pain/discomfort, anxiety & depression
- general population, RA, and OA
MACTAR:
What does it measure?
Scoring?
Population?
- assess disability in RA patients (specific patient- picked activities that are affected by RA)
- 5 activities
- questionnaire administered by PT
- 10-15 minutes
- -1 to +1 score (worse = better)
- RA (patient centered measure)
- better for short term follow up vs long term
Time Chair Stand Test:
What does it measure?
Scoring?
Population?
- lower body strength in older adults as an indicator of functional status
- some predictive validity for falls
standardized chair
- time for 1, 5, or 10 reps; or reps in 30 second period
- older patients with polymyositis, proximal LE weakness, RA, TJA, lower limb OA (orthopedic or arthritis conditions)
Knee Injury and OA Outcome Measure (KOOS) or HOOS:
What does it measure?
Scoring?
Population?
- short and long term patient relevant outcome measure of knee (or hip) injury that can result from traumatic OA
- 5 dimensions:
pain, other symptoms, ADLs, sport and recreation fxn, knee (or hip related) QOL - persons with ACL injury, meniscus injury, or post traumatic OA (same for hip injuries) aka hip or knee pathologies and post surgical
